How the Stimulus Does, Doesn’t Expand Health Insurance

By Sarah Rubenstein

The version of the economic stimulus bill that’s come out of the congressional conference committee has wins and losses for advocates of universal health care.

House Democrats in particular had tried to use the stimulus bill as a step toward universal coverage, pushing for expansions of laid-off workers’ access to Cobra coverage and Medicaid. Republicans had complained about some proposals, saying the Dems were using the stimulus bill to jump the gun with costly health-reform proposals that didn’t belong there.

The bill provides for subsidies for 65% of laid-off workers’ premiums for Cobra for up to nine months, at an estimated cost of $24.7 billion. That’s pretty much what the House had pushed for, except that it had wanted the subsidies to last a year instead of nine months. The Senate had called for 50% subsidies for a year.

Gone from the bill is a House proposal that would have lengthened the Cobra coverage for laid off workers who are 55 and older or had worked for their employer for 10 years or more. Under that proposal, those workers would have been able to stay on Cobra until they qualified for Medicare or got coverage through another employer’s plan.

Medicaid: Another casualty is the House’s proposal to allow unemployed workers to qualify for Medicaid regardless of their income or assets — an idea that Republicans had criticized. But the bill still has $87 billion in funding to help the states pay for their Medicaid programs.

For gobs of detail on how the Senate and House proposals melded into the compromise version, click here. Health care is toward the end of the document. A much briefer summary of the bill is here. The Kaiser Family Foundation also offers a summary of health provisions.

Comments (5 of 20)

CA Surgeon- I dont know about hairdressers, but I can assure you you will make more as a plumber than a surgeon - my take home per hour doubled when I did !

10:47 am February 17, 2009

GreenFrog wrote :

Peter W., patients have complete access to care! Hogwash! Perhaps that's true for government employees, but not for people with HMOs or PPOs. The employer, who subsidizes health care also chooses, via the insurer, what doctors and treatment employees can get.
Recall that 47,000,000 uninsured, and growing have little choice.
It's industry greed, unregulated, that is the cause.

10:11 am February 17, 2009

Peter W wrote :

Perhaps everyone should recognize advantages and disadvantages of our currrent system, and, the tradeoffs to universal coverage and/or government funded health care. There are three main constituents, doctors and the medical community, patients, and our legal system (including our government workers and elected officials). At this point, patients have essentially complete access to care, albeit with some red tape, the legal people have access to writing laws and winning awards, clout and compensation, and the doctors and medical providers continue to bear the brunt of cost control forcing lower supply of services, declining competition. These players, under the existing system, are not on equal footing, in fact, the legal group has the upper hand, while the patients, doctors and our population suffer. In fact, an illegal immigrant will receive essentially the same care at no cost, compared to a person on COBRA that now has to pay their actuarial share of octuplets from invitro fertilization. All the while, the legislators win clout, the legal groups have an addtional area to fight for "fair compensation" if even the most basic risk is incurred. The patient ignores the cost until they have to pay, and then, turn to the legislators to start the process all over again. Until we recognize that the tort system, patronage, and systemic greed are very strong drivers of cost, we will fact higher costs regardless of who pays, and in fact, a government system, will costs far more with less inovation. The parties have too much at stake to change, and government today has the upper hand.

2:57 am February 17, 2009

Benito Camarillo wrote :

Stop overpaying congressmen! Stop giving lifetime pensions to people who wouldn't qualify for one in a real profession or industry. Stop asking for handouts that encourage those idiot socialist democrats to think of more ways to collect and throw away!! Stop trying to screw with the pay and the careers of our Doctors and Nurses; Quit blaming them for reasons you can't manage your own healthy lifestyle and budget. Geeeeze stop whining and DO SOMETHING INTELLIGENT FOR A CHANGE! By the way, do you have any spare change I could have?

9:24 pm February 16, 2009

John Fembup wrote :

"the right to have universal health care no matter what it costs the government. "

Interesting point of view.

Anonymous, you seem unaware that Universal health care won't cost the government anything.